Ruxolitinib and Severe COVID-19.

Dear Editor:

We would like to share ideas on “Ruxolitinib and the Mitigation of Severe COVID-19: A Systematic Review and Meta-analysis [1].” Quiros et al. noted that “Prior studies on ruxolitinib have demonstrated it is able to decrease inflammatory ….. clinical investigation into ruxolitinib as a potential treatment approach for severe COVID-19.” Ruxolitinib is a new drug that is proposed for usefulness in management of COVID-19. Nevertheless, there is still no conclusion on its effectiveness. Quiros et al. tried to summarize and meta-analyze on effectiveness of ruxolitinib. However, there might be a problem on included studies for further analysis. The nature of included studies are not homogeneous and effectiveness of ruxoltinib is compared to different control alternative therapy in different included studies. Additionally, COVID-19 cases in different included studies are not clearly classified into severe infection group, hence, it is difficult to interpret for usefulness of ruxolitinib for management of severe COVID-19. This can lead to difficulty for final conclusion on effectiveness of ruxolitinib. Indeed, the same problem on meta-analysis of alternative management for COVID-19 is an important concern in interpretation of clinical investigation [2]. Good criteria for inclusion are important and determine the value of the meta-analysis. If there is a problem in recruitment, a bias might be possible.